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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: V / Permit Number: d " V R RECEIM D w w OC Building Permit Applicati n JUL g 0 2018 Planning and Development Services Building and Code Regulation Division Permitting Depa rtm e 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi t LU ountY, FL PERMIT APPLICATION FOR: Address: Legal Description: 4/T/-tE�2� Property Tax ID#: —z/® - 0 ego© - Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: OR Wrm, e�1120 VC- 4:X13-7-1A26, ?X i E91e?t.' C"AZ IA l G /D 6rO iP �F94 WA, ZN CCS SCC} ! NR' IWNNll { Additionalworkto a pe orme under this permit check k a that appy: Mechanical _Gas Tank _Gas Piping Shutters ✓ Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ -e-20 Utilities: —Sewer _Septic Building Height: 5YRf Name 1D%-101p Name: 17R" of e-64J2�5� Address: �. ✓Y! ,�.; ,�%D ilk Company: -./D-dAl C'ALz4J� City: State:_ Address: -tZZEIF::� A14J e5d 6412 Zip Code: Fax: City: ,�l�T e 11-- Y/ State:_jEL Phone No. Zip Code: 3! 6 � Fax: E-Mail: phone No 7 7 —.� Fill in fee simple Title Holder on next p e( f iffere& E-Mail from the Owner listed above) State or County Licensee:�'45?� 0 SZ ? If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: -,Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: - .Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects;:perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. N � Si a re of Owner/Lessee/Contract as Agent r Si ure of Contractor/License STATE OF FLORISTATE OF FLORIDA - =)=0 COUNTY OF =—g z COUNTY OF m�� > —w o 9cr r The forgoing instru t was acknowledged befor ¢ X The fojgoing instr t was acknowledge forew d this�dday of 20 by amu' -s this 110 day of 20 y 4#"r, ii 'A (O' d (Name of person acknowledging) (Name of person acknowledging) aLkU4/y (Signature of No ry Public-State of Florida U (Signature of Nota ublic-State of Florida) PersonallyKn wn OR Produced Identification / Personally ��cati�7.-n OR Produced Identificatior� Y Type of Iden ifica o Type of Iden Produced Produced Commission No. (Seal) Commission NO (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS ' 'VEGETATION SEATURTLE MANGROVE COUNTER - REVIEW REVIEW REVIEW REVIEW` REVIEW REVIEW DATE RECEIVED , DATE COMPLETED R—ev-77/2014